ICD-10 F03.90
Billable / Specific HCC v28: 52Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
About ICD-10-CM F03.90
ICD-10-CM code F03.90 represents Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F03). The 2026 edition of ICD-10-CM F03.90 became effective on October 1, 2025.
Coding Tips for F03.90
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
F03.90 is a CMS-HCC v28 risk-adjustment code (category 52). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under F03.90. Per CMS ICD-10-CM Tabular 2026.
- Dementia NOS
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for F03.90
Local Coverage Determinations (LCDs) from CMS MACs that list F03.90 as a covered diagnosis.
Showing top 10 of 423 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing F03.90.
3 Cigna
5 Medicare
CPT Codes Commonly Billed with F03.90
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- G0252 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- 78608 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- A9597 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- A9601 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- G0235 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- 78609 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- A9552 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- G0219 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- A9598 CMS LCD: Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions CMS LCD
- G0156 CMS LCD: Billing and Coding: Home Health - Psychiatric Care CMS LCD
Convert F03.90 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| F03.90 | 2900 | 10000 |
| F03.90 | 29010 | 10000 |
| F03.90 | 29011 | 10000 |
| F03.90 | 29013 | 10000 |
| F03.90 | 29021 | 10000 |
| F03.90 | 2908 | 10000 |
| F03.90 | 2909 | 10000 |
| F03.90 | 29420 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To F03.90
Other codes in section F01-F09 (Mental disorders due to known physiological conditions).
ICD-10 F03.90, Billing FAQ
Is ICD-10 code F03.90 billable? +
Yes, F03.90 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to F03.90? +
ICD-10 F03.90 includes: Dementia NOS.
Does F03.90 affect Medicare Advantage HCC risk adjustment? +
Yes. F03.90 maps to CMS-HCC v28 category 52. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with F03.90? +
Procedures frequently paired with F03.90 include: G0252, 78608, A9597, A9601, G0235.
What ICD-9 codes does F03.90 map to? +
Per CMS GEMs, F03.90 maps to ICD-9 codes: 2900, 29010, 29011, 29013, 29021. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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